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CPT 98962 Medicare Reimbursement & Commercial Rate Comparison
Medicare Reimbursement for CPT 98962
Non-facility rates apply in clinics or offices, where the provider covers all costs, so rates are typically higher.
Facility rates apply when services are done in hospitals or similar settings. Medicare covers overhead separately.
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$12.22
$12.02
$27.07
$12.12
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What is Medicare fee schedule?
The Medicare fee schedule is the list of payment amounts that Medicare uses to reimburse healthcare providers for services. It's updated annually and varies by geographic locality.
How are Medicare rates determined?
Medicare rates are calculated using the Resource-Based Relative Value Scale (RBRVS), which considers physician work, practice expenses, and malpractice costs, adjusted for geographic location.
Why do Medicare rates vary by location?
Medicare adjusts rates based on Geographic Practice Cost Indices (GPCIs) to account for differences in costs of living, wages, and practice expenses across different geographic areas.
What is Medicare Reimbursement?
Medicare fee schedules determine how much healthcare providers are paid for services.
These standardized rates help ensure consistent payment across the Medicare system while accounting for regional cost differences.
65M+
Medicare beneficiaries
across all 50 states
89
Medicare localities
with different rates
10,000+
Billable codes
in the fee schedule
All codes
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